There are numerous methods for dissolving pigment, but Hurst states that his personal preference is to employ chemical peels and micro-needling because they can be applied to a variety of skin types as long as the preparation time is correct. He claims that there are numerous techniques for breaking down the pigment. She clarifies, “This is so that you can have great, hydrated skin. As a result, recovery time will kept to a minimum, and outcomes won’t be impacted in any manner.”
Taylor suggested that for best results, you should set up your client’s pre-treatment care two to four weeks before their treatment program. The longer the home care, the better for darker skin tones, she continues. But, depending on the procedure, you might need to request that they stop using the goods three to five days beforehand, depending on the components.
While employing chemical peels or micro-needling, it is best to be gentle. Hurst stresses the need of beginning with a mild chemical peel and progress to more potent peels. You should thoroughly prepare your skin both at home and in the clinic for a deeper peel if you want to get rid of pigmentation swiftly.
Dr. Amado agrees, stating that pigmentation used to treated with micro-needling at a much deeper depth than it is now, therefore we must be delicate. Because we don’t want to overstimulate that basal cell, which could lead to further pigmentation, I’d use 0.5mm for hyperpigmentation.
Hurst claims that she does not like laser therapy. Laser therapy should use with the utmost caution because pigmentation can absorbed by the higher Fitzpatrick hues. If you are going to treat pigmentation, she advises treating a spot area first because you might be able to conceal the remainder of the skin.
It can be extremely risky to overtreat an entire area with ablative lasers, though. We wouldn’t use a milder form of IPL, despite the fact that it might be preferable.
To ensure a successful course of treatment, the underlying causes of melasma must addressed and, whenever feasible, eradicated. Hurst argues that in order to achieve the best results with a client who still has the trigger in place, you “need to work with the client.” “We can try giving the client tyrosinase inhibitors if we suspect that they may be a trigger and they are taking the birth control pill. You must, however, collaborate with the client.
“Melasma will largely go away after that hormonal excitement has passed, but it very well might be enlivened by the sun pushing ahead, so you truly need to practice homecare, tyrosinase inhibitors, and SPF,” advises Roylott-Byrd. As it is all hyperpigmentation, you can treat it similarly, however, you might only need to treat the affected area rather than the full face. Yet, it is crucial to show the patient that the treatment process is a partnership between you and the patient, regardless of whether you are treating melasma or hyperpigmentation.
How can I manage the expectations of my clients?
People are unaware that two to three days of unprotected UV radiation will undo everything you have done for an entire year, says Dr. Amado, who adds that “a good consultation will explain the science behind it.” Patients must dedicated, according to the expert, who claims that “if they are not going to utilize their SPF or their tyrosinase inhibitors, there is no use in doing chemical peels and micro-needling in the clinic since you will be battling against it all of the time.”
Since reprogramming the melanocytes—the cells that produce melanin—takes on average about 12 months, the program will be lengthy and will need to be maintained.
How should I modify my advice for home health care?
A few ingredients can support your clients’ adherence to their skincare routine and maintenance of results. Hurst suggests azelaic acid, kojic acid, tranexamic acid, vitamin C, licorice root, and AHAs such as glycolic, lactic, and mandelic. Moreover, Tri-Luma cream can be used to treat melasma.
According to Hurst, “vitamin A” and “green tea” are both great skin normalizers, and “Niacinamide has demonstrated to help manage hyperpigmentation.” Dr. Amado further suggests cysteamine. In addition, this substance blocks tyrosinase without having any negative effects. You can use it for a very long time without a prescription, she claims.
Maintaining progress and preventing pigmentation from returning necessitate the use of a broad-spectrum SPF.
Customers should continue using SPF throughout the day even though many individuals apply it first thing in the morning. However, for some people, reapplying SPF over makeup or around the eyes may be uncomfortable.
“My go-to is a physical mineral powder,” adds Hurst. As many consumers avoid applying SPF around their eyes because it runs and irritates them, the mineral powder is fantastic for this. To increase UV protection over makeup, she advises using a spray: “There are several fantastic sprays today, but ideally you want to reapply every couple of hours.”
lifestyle modifications
alterations to a person’s way of life Roylott-Byrd advises speaking with the customer about their lifestyle in order to prevent hyperpigmentation and melasma. SPF protection alone is insufficient. If it’s a bright sunny day, stay in the shade and put on a large hat and sunglasses. I see a lot of pigmentation just about where the sunglasses end since most individuals don’t apply their SPF near to their eyes, the dermatologist explains.
It is also crucial to talk about any hormonal abnormalities that might be present. Customers must understand their triggers. For instance, if you are aware that you are sensitive to oral contraceptives, she advises, “choose another means of contraception.”
